Organization
MICHAEL GRANT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL K GRANT PHARM (PHARMACIST)
(860) 869-7251
Entity
Organization
Contact information
Practice address
4 DADEN LN, WEST SIMSBURY, CT 06092-2703
(860) 869-7251
Mailing address
1492 HIGHLAND AVE, CHESHIRE, CT 06410-1287
(631) 843-0500
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
00011965
CT
Other
Enumeration date
09/05/2016
Last updated
09/05/2016
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